Spinal Stenosis

Spinal stenosis simply imples that there is a narrowing of the spinal canal. The term stenosis is used for many issues and always means a narrowing. In the spine, this leads to compression of the spinal cord and this pressure leads to pain and possibly numbness or weakness. The solution to the spinal stenosis is to reduce the pressure on the spinal cord. There are two ways to do this, decompression or fusion. Decompression simply means that the bone or disc that is causing the pressure is removed. These types of procedures are often called laminotomies or laminoforaminoplasties. These procedures offer high success rates without a fusion and we recommend them. they can be done minimally invasively or conventionally but the end result is the same, to get the pressure of the spinal cord or its nerves. As for the second option, the fusion involves pulling the spinal bones slightly apart and fusing them in place. The belief is that the spine has become "unstable" and the disc has collapsed and thus by pulling the spine apart and fusing it there is an increase in space in the spinal canal. Often the fusion will also include removal of bone or disc and thus the fusion may include a decompressive element as well. My belief is that a fusion is often too much surgery for most problems but many spine surgeons utilize the fusion. The key to whatever surgery is done is to reduce the pressure on the spinal cord and its exiting nerves. An important point is about numbness and weakness, these imply nerve damage. Numbness is the lack of sensation and thus the compression has gone past the pain point to where you now feel nothing. Weakness is similar but involves the nerves that inneravte the muscles. Surgery for weakness or numbness might improve the symptoms but not always and thus even with surgery the weakness or numbness may be permanent. In the picture below, note how the